Long-term outcomes of adult medulloblastoma patients treated with radiotherapy.
J Neurooncol
; 136(1): 95-104, 2018 Jan.
Article
in En
| MEDLINE
| ID: mdl-29019042
ABSTRACT
Medulloblastoma (MB) is rare in adults and treatment guidelines are consequently not well-established. Few modern series have reported long-term follow-up and treatment sequelae. We examined long-term outcomes of adult MB patients at one institution. Records of 29 consecutive patients (18 male, 11 female) aged ≥ 18 years who received radiotherapy (RT) for primary MB from 1990 to 2016 were reviewed. Median age at diagnosis was 28 years (range 18-72 years). Seventeen patients were standard risk and 12 were high risk. Nineteen patients had gross total resection, seven had subtotal resection, and three had biopsy only. Median craniospinal irradiation and boost doses were 36 Gy (range 23.4-39.6 Gy) and 55.8 Gy (range 54-59.4 Gy), respectively. Of 24 patients receiving chemotherapy, 20 received concurrent + adjuvant and 4 received adjuvant only. At median follow-up of 9.0 years (range 1.1-20.5 years), five patients recurred four in the posterior fossa and one in both the posterior fossa and above the tentorium. Five patients died two of disease progression and three after possible treatment complications (seizure, lobar pneumonia, and multifactorial sepsis). At last follow-up, 23 patients were alive with no evidence of disease. Long-term effects include executive dysfunction (n = 17), weakness/ataxia (n = 16), and depression/anxiety (n = 13). Kaplan-Meier estimates of 10-year overall survival and failure-free survival are 83% (95% confidence interval [CI] 59-93%) and 79% (CI 55-91%), respectively. Despite encouraging disease control in this cohort, long-term sequelae may limit quality of life. Multimodality pediatric regimens using lower RT doses may be considered to reduce treatment-related morbidity.
Key words
Full text:
1
Database:
MEDLINE
Main subject:
Cerebellar Neoplasms
/
Medulloblastoma
Type of study:
Guideline
Limits:
Adolescent
/
Adult
/
Aged
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Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Neurooncol
Year:
2018
Type:
Article
Affiliation country:
United States